Tackling Health Inequities in Rural Ukraine: Evidence-Based Approach

Ukraine is experiencing an internationally recognized health crisis. Rural residents bear a disproportionate burden of this crisis due to challenging socioeconomic conditions in villages and disintegration of rural health care. Currently, Ukraine is piloting its first major health care reform, focused on changing the health care system from the patient-specialist to the primary care model. The reform has been critiqued for lack of attention to the social determinants of health and insufficient public consultation. Also, little is known from the Ukrainian rural population about their health concerns. This study attempts to bridge this knowledge gap in rural health policy in Ukraine. Fourteen interviews with health professionals and local representatives were conducted to identify the intermediate results of the pilot reform and barriers in accessing primary care in villages. The secondary analysis of five community consultations (funded by the Canadian Institutes of Health Research, PI – Dr. Olena Hankivsky) presents a picture of health concerns in rural Ukraine. Together, these findings inform the final recommendation, which combines community-level health initiatives, the creation of the Rural Health Framework and reviving the profession of a feldsher (analogous to a nurse practitioner) in Ukraine.